Provider Demographics
NPI:1912277898
Name:TPG HEALTH
Entity Type:Organization
Organization Name:TPG HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEWERFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-574-6603
Mailing Address - Street 1:24 N 9TH ST
Mailing Address - Street 2:STE A
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-3905
Mailing Address - Country:US
Mailing Address - Phone:515-574-6890
Mailing Address - Fax:
Practice Address - Street 1:625 L ST
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5706
Practice Address - Country:US
Practice Address - Phone:515-574-3015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TPG HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography